Measles

Description

Measles

This is a contagious disease, characterised usually by fever, cough, and a rash upon the skin. The disease commences with feelings of lassitude, chilliness, aching in the limbs, followed by a frequent pulse, heat and dryness of the skin, headache, redness of the eyes, loss of appetite, furred tongue, sore throat, sneezing and discharge of tears, huskiness of voice, cough, and sometimes tightness of the chest and shortness of the breath. In some cases pains in the stomach, nausea and vomiting. In young children, convulsions are not unfrequent, particularly during the time of teething. There is considerable variety in the violence of the disease, and in the number of the symptoms. Occasionally there are nothing more than the ordinary symptoms of moderate catarrh, with little or no fever; while in other cases the fever is high, and there are symptoms of bronchial or pulmonary disease. The symptoms usually increase in severity for two or three days, till about the third or fourth day the rash appears. Sometimes, however, the rash is considerably longer before it makes its appearance. The rash usually appears first upon the face and neck, then upon the body, and lastly upon the limbs; sometimes, however, it appears upon the body or limbs first. When at its height, which is usually upon the second or third day of the eruption, there is frequently a troublesome itching and heat of skin. Sometimes the cough begins to abate on the appearance of the rash; occasionally the voice will be quite lost for two or three days, and the patient can only speak in a whisper. About the eighth day of the disease, or the fourth of the eruption, the symptoms begin to decline. In some cases, however, the whole duration of the eruption does not exceed a day or two, and in others it lasts for a week or more. The red colour of the eruption gradually gives way to a dirty yellowish hue, and the eruption dries up, and separates in fine scurfy scales. The falling off of the scales is usually attended with a little itching.

Occasionally, instead of the symptoms diminishing at this stage, there is strong evidence of inflammation of the bronchial tubes or of the lungs. This is the greatest danger of measles, and most frequently arises from bad nursing, the patient having been carelessly exposed to cold. Instead of inflammation of the chest, diarrhoea not unfrequently sets in, which, when moderate, is sometimes a favourable sign, but it is sometimes obstinate and troublesome. Sometimes exposure to cold will drive in the rash, and the consequences are apt to be pains in the bowels, diarrhoea, shortness of breath, drowsiness, convulsions, or signs of great prostration.

Measles occasionally appears of a malignant character. Cases of this kind may sometimes arise from a depraved state of the constitution, with a strong predisposition to the typhoid condition, or the accidental conjunction of some powerfully depressing cause, with the specific cause of the measles. But more frequently they are the result of peculiarity in the cause of the disease. There is usually a greater frequency and feebleness of the pulse, the breath is more affected, with a greater tendency to delirium, stupor, or other nervous disorder. The eruption is apt to be irregular, and partial, appearing and then disappearing; and the rash is often of a livid, purplish, or blackish colour. The abdomen and brain are affected as in malignant typhus, and the contents of the chest are similarly attacked. When the patient survives the immediate danger from syncope, coma, or asphyxia, he is still liable to be carried off by the exhausting diarrhoea, or obstinate bronchial disease which remains. In consequence of the dark colour of the rash, this variety of measles has been called black measles. This state of the disease is fortunately rare.

But measles is liable to be complicated with other complaints, and many fatal cases occur in consequence. Among these may be mentioned inflammation of the bronchial tubes, of the lungs, or of the bowels. Sometimes measles occurs at the same time with scarlet fever.

Measles occasionally has the effect of relieving or permanently displacing other diseases. It is, however, much more apt to leave other disorders behind it. One of the most common of these is chronic inflammation of the air passages, with hoarseness; obstinate inflammation of the eyelids, inflammation and suppuration of the ears, swelling of the glands of the throat, boils in different parts of the body, and chronic diarrhoea are not uncommon. Measles is also well known to favour the development of tubercles and scrofulous swellings in those predisposed to them.

Measles occurs at all seasons of the year, but more frequently in cold weather. The disease is more common with children than with adults, although all ages are liable to be attacked, but it is one of those diseases that are seldom taken more than once.

This is one of those complaints in which much depends upon good nursing. The patient does not require to be kept hot, but always comfortably warm. Where there is so much risk of taking cold, and where the consequences are apt to be so severe, the patient,-particularly if a child, should be kept in bed, and carefully watched. The mother or nurse should bear in mind that "prevention is better than cure." Measles without cough may sometimes easily be mistaken for Scarlet Fever; and Scarlet Fever accidentally associated with cough has been taken for Measles.

Treatment

At the commencement,a mild aperient may be given, consisting of Rhubarb and Magnesia, or Senna Tea, or Tartarized Soda, with a little Ginger to prevent griping. Soothing drinks, such as Gruel, Barley-Water, Linseed Tea. If the cough is troublesome, the same mixture recommended under the head of "Whooping Cough" may be given, or the following: Take a new-laid egg, place it in a tea-cup, cover it with lemon juice (squeeze a lemon over it), let it stand till the shell is dissolved; add an ounce of honey, and beat the whole up together. A quarter of an ounce of Ipecacuanha Wine and half an ounce of Paregoric, may be added. A teaspoonful may be taken for a dose for a child of six or eight years old, and smaller doses for those of younger ages. Or the patient may take the Cough Mixture No. 10. As the patient progresses towards recovery, he may take bread puddings, rice, sago, chicken broth, followed by boiled chicken and boiled mutton. Benefit may frequently be derived from bathing the patient's feet in hot water, but they must be rubbed dry afterwards, and wrapped up in warm flannel, or covered with warm woollen socks.

Attempts have been made to produce a mild form of Measles by means of inoculation, in the same way as, before the discovery of cow-pox, people used to inoculate for small-pox. We are told of an instance in which the operation was performed in eleven hundred and twenty cases, and failed only in seven cases out of a hundred. The disease that resulted was mild, and in no case fatal. On the seventh day after inoculation, the fever appeared, on the ninth or tenth the eruption, on the fourteenth the skin began to peel, and on the seventeenth, the patient was quite well.